Displaying 128251-128260 of 1611142 results.
ID:
128251
Formulary ID:
00021052
Formulary Version:
17
Contract Year:
2021
RXCUI:
308979
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
128252
Formulary ID:
00021052
Formulary Version:
17
Contract Year:
2021
RXCUI:
197303
NDC:
Tier Level:
3
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
128253
Formulary ID:
00021052
Formulary Version:
17
Contract Year:
2021
RXCUI:
197304
NDC:
Tier Level:
3
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
128254
Formulary ID:
00021052
Formulary Version:
17
Contract Year:
2021
RXCUI:
197853
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
128255
Formulary ID:
00021052
Formulary Version:
17
Contract Year:
2021
RXCUI:
858813
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
60
Qty Limit Days:
30
ID:
128256
Formulary ID:
00021052
Formulary Version:
17
Contract Year:
2021
RXCUI:
858817
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
60
Qty Limit Days:
30
ID:
128257
Formulary ID:
00021052
Formulary Version:
17
Contract Year:
2021
RXCUI:
858810
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
60
Qty Limit Days:
30
ID:
128258
Formulary ID:
00021052
Formulary Version:
17
Contract Year:
2021
RXCUI:
308973
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
128259
Formulary ID:
00021052
Formulary Version:
17
Contract Year:
2021
RXCUI:
858824
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
ID:
128260
Formulary ID:
00021052
Formulary Version:
17
Contract Year:
2021
RXCUI:
858828
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
60
Qty Limit Days:
30
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